Opportunity Overview:
We are seeking a highly analytical, detail-oriented, and results-driven Data Analyst to join our dynamic Payment Integrity team. This role is critical in transforming complex healthcare claims, provider, operational, and financial data into actionable insights that improve business performance, optimize audit outcomes, and drive operational excellence.
The ideal candidate will be highly skilled at uncovering patterns in data, connecting the dots across multiple data sources, identifying process inefficiencies, and recommending corrective actions. You will partner closely with engineering, operations, audit, finance, product, and leadership teams to support strategic decision-making through advanced analytics, dashboarding, forecasting, automation, and performance measurement. This opportunity is ideal for a self-motivated professional who thrives in a fast-paced, high-growth environment and enjoys solving complex business problems through data.
What you'll do:
- Analyze large healthcare datasets including medical claims, audit outcomes, provider data, reimbursements, appeals, invoices, outreach activity, and operational performance metrics to identify trends, anomalies, and business opportunities.
- Build analytics to support provider outreach effectiveness, response tracking, follow-up performance, and provider abrasion control initiatives.
- Monitor and improve end-to-end audit lifecycle SLAs, turnaround time (TAT), queue aging, throughput, and productivity metrics.
- Perform invoice reconciliation by validating recoveries, fees, payments, billing outputs, and financial reporting accuracy.
- Build and maintain dashboards, scorecards, and KPI reporting using Power BI, Tableau, Looker, or similar tools.
- Develop automated daily, weekly, and monthly reports for operational, financial, and executive stakeholders.
- Be flexible and responsive in generating ad hoc reports and business analysis based on evolving operational priorities.
- Ensure all reports, dashboards, and published metrics are accurate, reconciled, and aligned across systems.
- Create profiling reports for auditors, providers, clients, claims inventory, productivity, and recoveries; continuously monitor for changes, trends, and performance drift.
- Detect operational drift, unusual patterns, leakage points, and inefficiencies; recommend corrective actions to improve overall process efficiency.
- Uncover hidden patterns in data and connect insights across multiple sources to support business decisions.
- Perform root cause analysis on missed recoveries, SLA breaches, provider abrasion, operational delays, and reporting variances.
- Use advanced analytics and forecasting to support staffing models, productivity planning, and business growth initiatives.
- Create and optimize complex queries, data models, and automated workflows using SQL and Python.
- Partner closely with operations, audit, finance, product, and leadership teams to support strategic decision-making through analytics and reporting.
- Maintain data governance standards and adhere to HIPAA and company privacy policies.
ISMS roles and responsibilities
- Fair understanding of Information Security practices.
- Align to the organization policies and procedures.
- Ensure to get updated with ISMS roles as assigned by the department/process heads.
Required Qualifications:
- 3+ years of experience in Data Analytics, Business Intelligence preferably healthcare Claims Analytics, or Payment Integrity Analytics.
- Advanced expertise in SQL including complex joins, CTEs, stored procedures, optimization, and large dataset handling.
- Strong hands-on expertise in Python for automation, reporting workflows, data transformation, and advanced analytics.
- Advanced proficiency in Microsoft Excel and Google Sheets including pivots, lookups, formulas, data validation, and dashboards.
- Experience with BI/reporting tools such as Power BI, Tableau.
- Proven ability to ensure reporting accuracy, reconcile numbers, and maintain trust in published metrics.
- Strong analytical mindset with ability to uncover patterns in data and connect the dots across multiple sources.
- High attention to detail with a strong focus on data quality and accuracy.
- Experience creating automated reporting suites, KPI dashboards, and executive scorecards.
- Experience monitoring productivity, SLA, TAT, queue health, financial metrics, and operational performance.
- Strong cross-functional collaboration skills and ability to work with operations, audit, finance, product, and leadership teams.
- Excellent communication skills with ability to translate complex findings into clear business recommendations.
- Strong prioritization, ownership mindset, and problem-solving capability.
- Bachelor's degree in Analytics, Statistics, Computer Science, Finance, Healthcare Administration, or related field.
Nice to Haves
- Knowledge of AWS services like Lambda, S3, EC2 and Textract.
- Strong experience in Payment Integrity operations, healthcare claims data, provider analytics, audit workflows, and financial reporting.
- Should have Intellectual curiosity to learn new things.
- Familiarity with version control tools such as Git.
- Experience using Jira for tracking requests, sprint planning, and workflow management.
Ability to commute/relocate:
- Hyderabad (Nacharam), Telangana: Reliably commute or planning to relocate before starting work (Preferred)
Interview Process*:
- Connect with Talent Acquisition
- Meet with the Hiring Manager
- Interview with Senior Leadership
About Cohere Health:
Cohere Health's clinical intelligence platform and agentic AI-powered solutions connect health plans' strategic goals and providers' needs, optimizing the speed, cost, and quality of care. With an enterprise approach that streamlines payer-provider decision-making across the care continuum–including policy, prior authorization, payment accuracy, and more–the company improves collaboration and reduces burden, resulting in up to 8x ROI and 94% provider satisfaction.
With the acquisition of ZignaAI, we expanded our AI-native platform with a comprehensive Payment Integrity Suite that spans data mining, clinical and coding validation, authorization and claims reconciliation, and end-to-end payment integrity services across pre- and post-pay workflows. By connecting clinical and payment insights, our transparent, AI-powered solutions help health plans proactively improve payment accuracy, reduce waste and vendor dependency, strengthen provider relationships, and build smarter, more efficient payment integrity programs.
Cohere Health's innovations continue to receive industry-wide recognition. We've been recognized on TIME's World Top HealthTech Companies 2025 list, the 2025 Inc. 5000 list, in the Gartner® Hype Cycle™ for U.S. Healthcare Payers (2022-2025), and ranked as a Top 5 LinkedIn™ Startup for 2023 & 2024.
We can't wait to learn more about you and meet you at Cohere Health!
Equal Opportunity Statement:
Cohere Health is an Equal Opportunity Employer. We are committed to fostering an environment of mutual respect where equal employment opportunities are available to all. To us, it's personal.
